Individual
COLLEEN BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2734 BEAVER RUN BLVD UNIT D, SURFSIDE BEACH, SC 29575-5392
(469) 353-4042
Mailing address
2734 BEAVER RUN BLVD UNIT D, SURFSIDE BEACH, SC 29575-5392
(469) 353-4042
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3360
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
04/23/2019
Last updated
02/06/2023
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